Managing Your Mental Health With Or Without Insurance Coverage

Numerous programs are available to help uninsured Americans who struggle with mental health issues. (NAPS)

by Transamerica Center for Health Studies

(NAPSI)—Mental health is synonymous with mental wellness. At some
point many people will struggle with their mental health. Just like caring
for physical health occasionally requires a visit with a physician, caring
for mental health may require visiting a mental health professional and, of
course, figuring out a way to pay for it.

Insurance Coverage and Payment
Options

When a person is unable to manage daily activities such as maintaining
fulfilling relationships, working productively, coping with the stresses of
life, or even recognizing one’s own potential, he or she may be
struggling to stay mentally healthy—whether he or she is able to
recognize it or not.

If a person has health insurance, it may be helpful to consult with a
primary care doctor who could make referrals to local services. When
individuals do not have a primary care doctor, they can also use their
insurer’s website or call center to locate mental health professionals
for treatment.

• Individuals who have insurance through an employer should check
the Summary of Benefits and Coverage for information on covered mental health
and behavioral services. The Transamerica Center for Health Studies (TCHS)
Consumer Healthcare Survey found that 54 percent of respondents have access
to employer-sponsored programs for mental health or substance abuse, but only
21 percent of employees were enrolled in these programs.

• The Affordable Care Act requires health insurance purchased
through the state Exchange to cover mental health, substance use disorder
services and behavioral treatment for current or pre-existing conditions.

• Poor access to and treatment for mental health can be debilitating
for veterans. VA Care is provided at government-owned facilities for veterans
only, while TRICARE is the government-provided insurance plan for active-duty
or retired service members (and their dependents) at private and public
facilities, or military health clinics and hospitals. The VA also offers
Service-Connected Disability Compensation, which provides a tax-free monthly
benefit for veterans who are at least 10 percent disabled because of injuries
or diseases that were incurred in or aggravated during active duty, active
duty for training or inactive duty training.

• Medicare is a government-funded program that covers almost every
senior citizen in the United States. Medicare Part B covers a free yearly
depression screening, mental health counseling or therapy visits, as well as
outpatient services such as individual and group psychotherapy. The costs and
drugs covered with Medicare Part D Prescription Drug Plan will vary by plan,
but almost all drugs classified as antidepressants, antipsychotics and
anticonvulsants are required to be covered.

Options for the Uninsured

According to a 2017 report from Mental Health America, more than 7.5
million people with a mental illness are uninsured. Paying for mental health
services without insurance can be costly, but there are some options
available, including:

• Medicaid—A joint
federal and state program that provides free or low-cost health coverage for
disabled persons, low-income adults, and pregnant women. Every state
implements its own guidelines, so coverage may vary. For years, Medicaid has
been the largest payer of mental health−related services in the United
States.

• Children’s Health
Insurance Program (CHIP)—In 2017, an estimated 9.4 million children
were covered under CHIP, funded jointly by states and the federal government
for uninsured children up to age 19. Like Medicaid, CHIP guidelines are also
implemented by each state, so eligibility for coverage may vary.

In addition, there are many facilities and centers that provide services
for those with mental health and or substance use disorder needs at a lower
cost or work within a patient’s insurance policy:

• Mental Health America
affiliate locations are nonprofit organizations found in 41 states that help
patients navigate the mental health system, providing education, support
services and rehabilitation services.

• With more than 1,000 National
Alliance on Mental Illness (NAMI) affiliate locations and state
organizations, NAMI lists free resources and educational programs.

• Certified Community
Behavioral Health Clinics receive Medicaid reimbursement for their mental
health and substance use disorder services, including 24-hour crisis care
coordination, evidence-based practices and integrated physical care. These
facilities are currently available in eight states: Minnesota, Missouri,
Nevada, New Jersey, New York, Oklahoma, Oregon and Pennsylvania.

For more information,
including the Exchange guide and State-by-State Medicaid Guide, visit the
TCHS website (www.TransamericaCenterforHealthStudies.org).
Transamerica Center for Health Studies is a national nonprofit dedicated to
researching health care issues facing employers and consumers today.